YOUR WORK

In this role, you will:

• Regularly contact internal and external customers and business partners to verify or obtain additional information to complete processing work
• Refer discrepancies in source documents to appropriate person and assist in correcting the document
• Monitor schedules, workflow, and priorities, communicating with supervisors/team members as needed to ensure effective teamwork
• Assist in process-related issues and acts as a resource for process related issues/problems and their resolution
• Make recommendations to management for improvements in business processes and desk-level procedures
• Manage inventory across multiple lines of business, ensuring cycle times, service level agreements and performance guarantees are met
• Direct and coach team members to ensure production and quality measures are met on a monthly basis, in partnership with the supervisor
• Act as a back-up for supervisor, leading calls, team huddles and representing the department with internal and external stakeholders
• Partner with internal and external stakeholders to ensure customers receive high-quality, consistent experience
• Manage department specific desktop level procedures, training content, and projects as warranted by business needs

YOUR KNOWLEDGE AND EXPERIENCE

• Requires a minimum of 7 years of relevant experience
• Requires Advanced-Expert skills creating documents/files using Excel, Outlook, Power Point, and Word
• Requires Health Plan Operations Group level experience (i.e. claims, billing, processing, etc.)
• Requires experience working cross-functionally and explaining complex concepts at all levels
• Experience with Facets and Salesforce, a plus
• Experience leading a team, providing coaching and feedback, reporting out on inventory, prioritizing tasks, leading meetings
• Self-driven and able to operate in the best interests of our clients, our company, and team with limited supervision or oversight

YOUR ROLE

The Group Eligibility Install and Renewal team is responsible for the review and installation of new and renewing small and large group business as well as ongoing maintenance. The Eligibility Processor, Specialist will report to the Supervisor, Group Eligibility, Install and Renewal. In this role you will work alongside the Supervisor, Operations to manage and report out inventory, attend and lead calls with team members and other internal business partners, provide coaching on complex cases and ensuring production and quality are meeting service level expectations.

In this role, you will:

• Regularly contact internal and external customers and business partners to verify or obtain additional information to complete processing work
• Refer discrepancies in source documents to appropriate person and assist in correcting the document
• Monitor schedules, workflow, and priorities, communicating with supervisors/team members as needed to ensure effective teamwork
• Assist in process-related issues and acts as a resource for process related issues/problems and their resolution
• Make recommendations to management for improvements in business processes and desk-level procedures
• Manage inventory across multiple lines of business, ensuring cycle times, service level agreements and performance guarantees are met
• Direct and coach team members to ensure production and quality measures are met on a monthly basis, in partnership with the supervisor
• Act as a back-up for supervisor, leading calls, team huddles and representing the department with internal and external stakeholders
• Partner with internal and external stakeholders to ensure customers receive high-quality, consistent experience
• Manage department specific desktop level procedures, training content, and projects as warranted by business need